RSS Feedhttp://10.40.239.129/blogs/rss-feed/Blog RSS Feeden{29700F0E-591F-4173-BD05-2987EAF6A6AD}http://10.40.239.129/blogs/2015/03/how-can-i-lose-weight-while-breastfeeding/How Can I Lose Weight While Breastfeeding<p>One thing that might be on your mind after you have your baby is, "How do I lose all this baby weight?" It is tempting to think the fastest weight loss solution is to turn to crash diets and exercise frenzies. If only that worked! In fact, this quick-fix approach can negatively affect your breast milk supply. </p>
<p>With the right approach though you can definitely lose weight while breastfeeding. Consult with your doctor first to make sure now is the right time for you to began a diet and exercise plan. Then check out this video where I share a few important things to keep in mind: </p>
<p><strong>Diet</strong></p>
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<p>It is important to remember that you essentially put in your milk supply for the whole breastfeeding experience during the first two months after your baby is born. You need to make sure you're getting enough calories to provide for your body's needs as well as for the milk that you're making for your baby. If you're exclusively breastfeeding, you need about 400-500 extra calories a day as compared to only about 300 extra calories during pregnancy. People feel like they can eat for two while they're pregnant, then go on crash diets after delivery. Unfortunately dieting like that can cause problems with your milk supply. </p>
<p>Instead of cutting calories, fill your diet with good, healthy foods. Try eating more whole grains, fruits, and vegetables, and start incorporating good lean proteins and low fat dairy into your meals. Also be sure that you're well hydrated, especially if you're exercising. If you don't drink enough water or eat enough healthy calories, you might see your milk supply decrease. </p>
<p> <strong>Exercise</strong> </p>
<p>When it comes to exercise, be careful when you start. You need to give your body, especially your uterus, time to totally heal. The vessels that were feeding your baby are still there after your baby is born, and your uterus needs to clamp down like a tourniquet to control the bleeding. If you increase activity too soon, you can start to bleed again. Most doctors recommend that you don't start vigorous exercise until about six weeks after a vaginal delivery and about eight weeks after a C-section. <br />
<br />
After that waiting period you can start any exercise program that you feel is going to suit you well. You should aim to exercise a minimum of 30 minutes on most days of the week. But don&rsquo;t stress about it too much. Just do as much as you can and develop a routine. It&rsquo;s possible even with a newborn! You will likely be very tired from sleep deprivation, but you'll find that exercise actually helps increase your morale and make you feel better about things overall. </p>
<p>Aim to get your heart rate up and into a good fat-burning zone. There are many target heart rate calculators on the Internet that can help you determine what is the best rate for your weight, height, and age. Try incorporating some strength training exercises into your workout as well. These help rev your metabolism and burn fat and calories even at rest. </p>
<p><strong>Your Milk Supply</strong> </p>
<p>Generally, women don't notice a decrease in their milk supply when they start exercising. It is possible though, regardless if you are eating and drinking enough. Here are some techniques you can try before you forgo exercising all together. </p>
<ul>
<li>Cut back the intensity of your workout. </li>
<li>Try feeding your baby more frequently throughout the day. For example, if your baby normally eats every 2-3 hours, throw in an extra feeding every now and then during the day.</li>
<li>If you have a pump available to you, pump for 10 minutes after each nursing session during the day. </li>
</ul>
<p>Remember, it took nine months to put the weight on and it could take that long to get it off. As you continue to eat well and add exercise to your regular routine, you&rsquo;ll probably notice that the weight will come off naturally, all without affecting your milk supply. Just set realistic goals and expectations for yourself and enjoy this time with your new baby!</p>
<p>If you have any questions, please feel free to ask them on our Facebook page, <a href="https://www.facebook.com/intermountainmoms">Intermountain Moms</a>, and recommend us to your friends and family too.</p>Mon, 02 Mar 2015 00:00:00 -0700{BEF7D88A-EF4C-4DF4-8CF9-1AF5AB9C98B5}http://10.40.239.129/blogs/2015/03/what-can-you-do-to-protect-your-family-heart-health-from-air-pollution/What Can You Do to Protect Your Family&#39;s Heart Health from Air Pollution<p><span style="line-height: 1.4em;">&ldquo;Usually we get one or two severe heart attack patients who arrive at our emergency room daily,&rdquo; said Dr. Muhlestein.. &ldquo;But instead of one or two, we had six or seven patients with heart attacks during a particularly unhealthy air day. From my experience, I believe that a even a single day of unhealthy air places people at greater risk for heart attack.&rdquo;</span></p>
<p>So, what can you do to protect your family? Dr. Muhlestein recommends that you do four things to help protect your family&rsquo;s hearts:</p>
<p><strong>Pay attention to the air in your home</strong></p>
<p>Be sure indoor air is free of smoke, dust and chemical fumes. Some ways to improve the air quality in your home include: using a damp rag instead of a feather duster when dusting, regularly checking and replacing your furnace filter, and make your home a Smoke-free Zone. <strong></strong></p>
<p><strong style="line-height: 1.4em;">Listen to your body</strong></p>
<p>Get to know your own responses during unhealthy air times&ndash; and when you need to change your plans.</p>
<p><strong>Get to know your neighborhood</strong></p>
<p>Pay attention to places and times of day where air quality affects you the most.</p>
<p><strong>Learn more</strong></p>
<p>Get more information about how you can improve air quality &ndash; both outdoors and in your home. <a href="http://www.ucair.org/" target="_blank">Utah Clean Air</a>, <a href="http://airnow.gov/" target="_blank">AirNow.gov</a>&nbsp;and the <a href="http://epa.gov/airquality/" target="_blank">Environmental Protection Agency</a> are great resources. </p>
<p><strong>What Should You Know about Air Quality?</strong></p>
<p>The Air Quality Index (AQI) measures how clean or unhealthy the air is everyday. An AQI above 101 is considered unhealthy due to the number of particulate matter in the air. </p>
<p>Particulate matter is made of tiny particles in the air like dust, dirt, soot, and smoke. In northern Utah, high rates of particulate matter are more common and more problematic in winter months &ndash; which is what causes our winter inversions. </p>
<p>&ldquo;If you have heart disease or an underlying heart condition, particulate matter floating in the air can increase your risk of experiencing a heart attack,&rdquo; said Dr. Muhlestein. &ldquo;During unhealthy air quality days, everyone, but especially those with heart disease, should change their behaviors to avoid or limit their time outdoors.&rdquo;</p>
<p>Particulate matter is often reported as PM 2.5 or PM 10. Both are extremely tiny. It would take five PM 10&mdash;or 20 PM 2.5&mdash;particles to span the width of a human hair. Your nose and airways can filter out the larger particles from the air you breath before they reach your heart or lungs, but smaller particles can get into your blood and cause blood vessels to narrow, thus increasing your changes of developing serious health problems.&nbsp;</p>Mon, 02 Mar 2015 00:00:00 -0700{039CD399-1414-4D3D-B275-95D5E5F369B5}http://10.40.239.129/blogs/2015/03/orthokeratology/Orthokeratology<p>Orthokeratology, also referred to as Ortho-K or Corneal Reshaping Technique (CRT), is a non-surgical therapy for temporarily reducing nearsightedness.&nbsp; Specialty lenses are worn at night to change the shape and curvature of the cornea and eliminate the need for glasses the next day.</p>
<p>Many people compare sleeping in Ortho-K lenses to wearing a dental retainer to maintain teeth alignment.&nbsp; The lenses gently reshape the cornea through the night so that during the day, individuals can experience clear distance vision all day long without the need of glasses or contact lenses.&nbsp; Patients who use the reshaping lenses often experienced improved vision after the first night of wear; however, it may take a few weeks to achieve consistent vision that last all day long.</p>
<p>The prime candidates for Orthokeratology include: </p>
<ul>
<li>nearsighted individuals under 40</li>
<li>correction under -5.50 diopters</li>
<li>patients who have poor results wearing contact lenses or glasses</li>
<li>athletes or active individuals</li>
<li>children with early developing nearsightedness </li>
</ul>
<p>Children are especially successful with corneal reshaping and studies have shown a decrease or slowing progression of near sightedness when using Ortho-K lenses.&nbsp; </p>
<p>Orthokeratology provides an alternative to surgical procedures such as LASIK or PRK that can be expensive and permanently change the shape of the cornea.&nbsp; Corrective surgery is also not recommended for patients under 21 or whose vision is still changing.&nbsp;&nbsp; Orthokeratology allows young adults and children to have clear vision without glasses or surgery. </p>
<em>For more information about Orthokeratology and corneal reshaping visit the Salt Lake Clinic site by clicking here (Link to </em><a href="http://bit.ly/SLC-ortho-k" target="_blank"><em></em></a><a href="http://bit.ly/SLC-ortho-k"><em>http://bit.ly/SLC-ortho-k</em></a><em></em><em>)</em>Mon, 02 Mar 2015 00:00:00 -0700{D48E2475-630A-4916-BA99-3D5F3DE72942}http://10.40.239.129/blogs/2015/02/set-a-sit-and-screen-limit-as-part-of-your-move-more-goal/Set a &quot;Sit and Screen Limit&quot; as Part of Your MoVe More Goal<p>Have you joined the activity tracking craze as part of your attempt at being more mindful of your physical activity on a daily basis?&nbsp; <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3618375/">Studies show</a> that by taking the few minutes each day to log your workouts, track you steps, or time your sleep, improves your overall awareness of lifestyle choices and influences healthy decision making.&nbsp; Have you ever considered tracking your screen time or your sitting time?&nbsp; Take the challenge; yourself, as a family, or with your workout partner to track your screen time and sitting time for a week.&nbsp; Teens screen time average is about 5.5 hours a day for girls, nearly 7 hours for boys, and adults spend an average of 9.3 hours a day sitting.&nbsp; If you are shocked by your results, perhaps you can put some <a href="http://www.nytimes.com/2013/02/10/opinion/sunday/relax-youll-be-more-productive.html?pagewanted=all&amp;_r=0" target="_blank"></a><a href="http://www.nytimes.com/2013/02/10/opinion/sunday/relax-youll-be-more-productive.html?pagewanted=all&amp;_r=0">creative problem solving</a> skills to work to increase your active time while you have to be in front of a screen.</p>
<p>There is ongoing <a href="http://www.reuters.com/article/2015/02/03/us-teen-sleep-screen-time-idUSKBN0L72F420150203">research</a> with results that link excessive screen time with many health problems and risks.&nbsp; One study suggests that teens who spend more than the recommended screen time limit of 2 hours a day is linked to poor school performance, increased mood disorders, and depression.&nbsp; Screen time within an hour before bedtime or for more than 4 hours a day has been associated with sleep disturbances, including needing more than an hour to fall asleep.&nbsp; </p>
<p>What happens if you add a <a href="https://www.youtube.com/watch?v=M2NHvpM9PWU">desk job</a> to the mix, or your nightly habit of tuning in to wind down, or the Netflix binge watching to tune out other stress?&nbsp; Chances are, when you finally turn out the blue lights, it is curtain call for the big screen in your brain that finally has an uninterrupted moment to then try to sort out the problems of the day and review unfinished task lists.&nbsp; Restlessness settles in from too much sedentary time throughout the day to physically be tired enough to drift to sleep.&nbsp; Perhaps it is this <a href="https://www.youtube.com/watch?v=ZHEUD2q-PC4">repeated pattern</a> that leads to fatigue during the day, decreased energy levels that make it easier to justify putting off your workout until another day, and tempting to fueling up on a quick fix energy dense snack in an attempt to overcome the midday lulls.&nbsp; </p>
<p>Put the research to the test and start tallying up the benefits you discover as a result of <a href="http://www.ted.com/talks/nilofer_merchant_got_a_meeting_take_a_walk?language=en" target="_blank">sitting less</a> and moving more: improved energy, strength, and endurance; increased productivity and focus; restful sleep and improved daytime alertness.&nbsp; </p>
<p>Need some <a href="http://intermountainhealthcare.org/live-well/move-well/habits/limit-screen-time">suggestions</a> to get started? </p>
<ul>
<li>Set a timer the next time you sit to start a task and &ldquo;set your sit limit&rdquo; to get the job done.&nbsp; Then get up and move.&nbsp; </li>
<li>Schedule your time for fitness just as you would any appointment.&nbsp; At the beginning of each week put it on your calendar and plan to make it happen.</li>
<li>Talk to your kids about the health risks of too much screen time and challenge them to set a screen limit.&nbsp; </li>
<li>Try reaching a 5000 step total as a prerequisite to tuning into the TV or gaming.</li>
<li>Set a bedtime alarm on your watch or phone to remind you to honor your body&rsquo;s need for adequate sleep.&nbsp; </li>
<li>Raise your desk to standing height or mount a shelf to your treadmill or stationary bike to allow for moving options when your would normally sit to surf, sort emails, or study.&nbsp; </li>
<li>Avoid lunch breaks at your desk, take the few extra minutes to go outside and give your brain a break.</li>
<li>Adopt a homeless dog and gain an always ready and willing walking partner.</li>
<li>Decide to walk or bike errands that are within a 2 mile radius of you home.&nbsp; Then, store your car keys in your bike lock as a reminder.</li>
<li>Turn off the TV and turn on the tunes, then dance around the kitchen while making dinner.&nbsp; </li>
</ul>
<p>The key to remember is you are your best health advocate and committing to taking care of yourself as a daily priority is only something you can decide to do.&nbsp; You can start by making it a goal to MoVe More as part of your plan to LiVe Well.</p>
<br />Fri, 27 Feb 2015 00:00:00 -0700{B366B6BC-0C14-434B-B59A-F6BD78845A1F}http://10.40.239.129/blogs/2015/02/heart-failure-your-pathway-to-treatment/Heart Failure: Your Pathway to Treatment<p>Heart failure, or weakening of the heart muscle resulting in a limited ability to pump blood, is a common problem affecting approximately 5 million Americans. It is the only major cardiovascular disorder that is on the rise. The number of deaths in the United States from heart failure has more than doubled since the late 1970s. Roughly 400,000 to 700,000 new cases are diagnosed and approximately 250,000 Americans die annually from this condition.<br />
<br />
Many people with heart failure do not know that they have it as they attribute many of its symptoms to getting older. Although heart failure can develop suddenly, most often its development is a gradual process where symptoms tend to get worse with time. </p>
<p>Common symptoms of heart failure include: </p>
<ul>
<li style="color: black;">Shortness of breath, which can happen even during mild activity</li>
<li style="color: black;">Difficulty breathing when lying down</li>
<li style="color: black;">Weight gain with swelling in the legs, ankles, or fullness in the abdomen from fluid retention</li>
<li style="color: black;">General fatigue and weakness&nbsp; </li>
</ul>
<p>Heart failure can be caused by a number of problems within the heart. Heart attacks, high blood pressure, problems with heart valves, or long-standing problems with heart arrhythmias, where the heart can beat very fast, can all weaken the heart over time. Sometimes heart failure can run in families and it can also happen during pregnancy. </p>
<p>If you have the symptoms listed above, you should talk to your primary care provider about how you are feeling. Your primary care doctor will assess your symptoms and may request that you receive an ultrasound of the heart, an echocardiogram, to check your heart&rsquo;s structure and function. The echocardiogram will determine if the pumping capability of your heart is normal, or if it is not moving as much blood forward each beat as it should. In addition moving blood forward in a squeezing motion, hearts also need to be able to relax after they squeeze to allow new blood to enter the heart. If the heart muscle can&rsquo;t relax, fluid can back up into the lungs, abdomen or legs and cause symptoms of heart failure.&nbsp; </p>
<p><strong>Treatments for Heart Failure</strong></p>
<p>If you, a friend, or a family member is diagnosed with heart failure, there are many treatment options available. If your heart does not pump blood forward as well as it should, you may need to undergo an evaluation of the arteries of your heart to determine if the arteries are causing one or more of the walls of the heart to move abnormally. Various laboratory tests can aid in looking for a cause of heart failure. </p>
<p>Regardless of the underlying cause, if your heart does not pump blood forward as it should, there are two main classes of medication &ndash; beta-blockers and ACE-inhibitors &ndash; that have been shown in research trials to help strengthen the heart over time. Common beta-blockers are metoprolol succinate (Toprol XL) and carvedilol (Coreg) and common ACE-inhibitors are lisinopril and enalapril. These medications work by blocking certain stress hormones in the body responsible for the progression of heart failure. Trials have shown beta-blockers to decrease the incidence of death by up to one-third in heart failure patients. These medicines often need to be initiated at low doses, and then the dose of the medication is increased at subsequent visits as blood pressure and heart rate allows.&nbsp; </p>
<p>If you are troubled by water retention and swelling, your doctor may give you a prescription for a fluid medication to help your kidneys remove the excess fluid. Eating a low salt diet and keeping track of your blood pressure and daily weight will help your doctor manage your medications appropriately. With time, you can also learn how to assess your symptoms and adjust your fluid medication on your own to avoid episodes of swelling and increased shortness of breath. </p>
<p><strong>Heart Failure Pathway</strong></p>
<p>If you are diagnosed with heart failure, the cardiology team at the Intermountain Heart Institute has a new program available called the Heart Failure Pathway to get you started on the right track. The doctors in the Heart Failure Pathway will assess your symptoms and get you started on medications that will get you back to the activities in life that matter to you. The doctors in the Pathway will see you every two weeks to adjust your medications to the doses that have been shown to improve the strength and function of the heart in clinical research trials. If you have been diagnosed with heart failure and you and your doctor wish for you to receive your care through the Heart Failure Pathway, you can call 801-507-3500 to set up an appointment, which will be provided within seven days. </p>
<p>If you are diagnosed with very advanced heart failure, you may be referred to the Advanced Heart Failure/Transplant clinic. If despite appropriate medications and potential procedures, including repair of heart arteries or valve issues, your heart is still very weak, you may be a candidate for advanced therapies. Advanced therapies include intravenous medications to help the heart pump (inotropes), an artificial heart (left ventricular assist device), or heart transplant. </p>
<p>Heart failure is a common problem with a wide spectrum of severity. If you or a family member has symptoms suggestive of heart failure, please seek medical attention. There are many therapies that have the potential to strengthen the heart with time and get you back to things that you enjoy most. </p>
For more information about heart failure, we invite you to speak with a cardiologist. To find a provider near you, visit <a href="http://www.IntermountainHeartInstitute.org" target="_blank">www.IntermountainHeartInstitute.org</a>.Thu, 26 Feb 2015 00:00:00 -0700{C1D7AAF5-06EB-45BF-BF79-A8F00B5FAEBE}http://10.40.239.129/blogs/2015/02/hyperbaric-oxygen-therapy-saves-toes/Hyperbaric Oxygen Therapy Saves Student&#39;s Toes<p>An interesting case recently came through the Intermountain Orem InstaCare, a case that illustrates the importance of seeking medical treatment as early as possible.</p>
<p>A young man went out to hike &ldquo;Y&rdquo; Mountain in Provo with a group of friends in the late afternoon on a fairly warm January day.&nbsp; As the elevation got higher and nighttime fell, the snow starting getting deeper so the young man pleaded with his group to turn around since he was only wearing gym shorts and thin tennis shoes. He was &ldquo;outvoted&rdquo; by the group twice. </p>
<p>At one point, this young man lost a shoe without knowing it (due to numb feet) and hiked at least a half mile in his sock. He took his shoes off (with pliers) twice &ndash; once to rub his feet and once to warm by a fire. The socks were beaded with ice crystals the entire time. When he finally made it home, he rewarmed again in the shower, but both of his shins had lost an entire layer of skin from being scraped against frozen snow. After a fair amount of coercion, his friends took him to find a doctor, eventually ending up in the InstaCare only minutes before it closed.&nbsp;&nbsp;</p>
<p style="text-align: center;"><img height="1200" alt="A close-up look at the effect of frostbite and shin abrasions caused by snow" width="396" src="/~/media/Images/Modules/Blog/Posts/2015/frostbite-patient-details.jpg" /></p>
<p>In addition to horrible-looking shin abrasions, the patient had early signs of frostbite &ndash; swelling of the toes with purple discoloration of the tips. In the left foot, this extended along the entire sole of his foot to the heel with no feeling in these areas. Having seen frostbite on multiple occasions, usually after the patient waited 24 hours or more when the damage is set, I was pleased he had come in early. We immediately started him on a blood thinning agent to help improve flow and initiated hyperbaric oxygen therapy. This is an investigational use for hyperbaric medicine. But with no better options for treatment, it was our best chance to try and save his toes. &nbsp;</p>
<p> </p>
<p>Frostbite starts with freezing of the skin and then progresses to deeper tissues like muscles and bone as it worsens. The blood vessels are damaged in the earliest stages, causing a diminished flow of oxygen to the affected area, thereby increasing damage from freezing. Lack of blood flow and oxygen also inhibits the body&rsquo;s natural repair mechanisms, which utilizes oxygen.&nbsp; </p>
<p> </p>
<p>Since hyperbaric oxygen therapy has a well-documented, scientific evidence base for healing wounds affected by diminished blood flow, it makes sense that it will treat some of the damaging effects of frostbite and limit further tissue injury. Hyperbaric treatment delivers oxygen in such high concentrations it&rsquo;s able to bypass the obstructed vessels to prevent further damage to deeper structures while promoting early repair mechanisms as long as the tissue destruction is not complete. </p>
<p> </p>
<p>Although the young man lost a deep layer of skin from his shins, we were very successful in saving his toes from further frostbite damage. After five days of twice daily treatments, he began to recover feeling and color to the toes, ultimately without any skin loss. </p>
<p> </p>
<p>In addition to possible treatment options for frostbite, there are several other lessons to be learned from this story:</p>
<ol>
<li><span style="line-height: 1.4em; text-indent: -0.25in;">Even with mild temperatures, it&rsquo;s always unsafe to be caught outdoors without adequate winter clothing. More deaths from hypothermia occur in the 50-60 degree range than lower temperatures.</span></li>
<li>When doing activities in a group, decisions should be made in favor of protecting the most susceptible individual. Majority rules should not apply when one member is at risk.&nbsp; </li>
<li>Early treatment is always better. If this young man had waited until Monday as his friends suggested, he would have lost at least one full toe, the tips of several others and likely the sole of his left foot.&nbsp; The signs of frostbite are usually subtle in appearance in the early stages. When the toes turn dark or even black, it&rsquo;s too late to save them.</li>
</ol>
<br />
<p><br />
</p>Wed, 25 Feb 2015 00:00:00 -0700{EF1C09CC-2618-4870-B8B3-47AF67A0417E}http://10.40.239.129/blogs/2015/02/stress-and-heart-disease/Stress and Heart DiseaseStress can either be mental or physical. Mental stress, the type we address in this article, is a situation perceived as an uncontrollable threat to an individual&rsquo;s well-being. Our responses to stress have evolved because it is critical to survival in a dangerous and hostile environment. These responses prepare one for either fight or flight. So how does stress affect the cardiovascular system?
<p>&nbsp;</p>
<p>Mental stress is a risk factor for cardiovascular disease, or CVD, according to both experimental and clinical evidence. Mental stress may cause: </p>
<ol>
<li style="color: black;">Increased sympathetic activity, or the fight or flight response, leading to increased blood pressure levels and pulse rates. </li>
<li style="color: black;">Reduced insulin sensitivity or intolerance to glucose and diabetes. </li>
<li style="color: black;">Increased blood clotting and blood vessel dysfunction. </li>
<li style="color: black;">Reduced blood flow to the heart.&nbsp; </li>
</ol>
<p>These findings suggest that mental stress may trigger the clinical events of coronary heart disease, particularly in the presence of advanced hardening of the coronary or heart arteries also known as coronary atherosclerosis. </p>
<p><strong>Role of Stress in Diabetes and High Blood Pressure</strong></p>
<p>The effect of mental stress on increased glucose intolerance or insulin insensitivity can lead to diabetes. Diabetes raises the risk of coronary heart disease; and the excess risk associated with mental stress may be, in part, made worse by diabetes. However, there are few medical studies that actually examine how much mental stress contributes to mortality as well as the occurrence of CVD.&nbsp; </p>
<p>One of the potential reasons for the excess risk of heart attack associated with mental stress is the effect this stress has on increased blood pressure levels and heart rates by increasing the body&rsquo;s fight or flight activities. </p>
<p>People who experience more elevated blood pressure response to mental stress tend to live with more atherosclerosis in the arteries that supply the heart with oxygen and nutrients it needs to pump. Studies show that these patients continue to experience ongoing hardening of these arteries.&nbsp; </p>
<p>Stress can raise blood pressure both immediately and chronically. Immediate stress, which is often called acute stress, is the tension one feels during an episode of fear or anxiety. Acute stress can cause a rapid and large increase in blood pressure and heart rate. But, it is usually short-lived. Patients who already have high blood pressure, often complain of symptoms such as dizziness, palpitations, and headache, which are also caused by anxiety. Panic attacks are common in the general population, but are more frequently seen in individuals with high blood pressure. </p>
<p>The role of chronic stress in contributing to high blood pressure is less clear &mdash; partly because chronic stress is so hard to measure. The perception of stress is largely subjective and experiences that may be stressful for one person may be much less so for another.&nbsp; </p>
<p>There is consistent evidence that &ldquo;stressed&rdquo; people in impoverished environments, or those who move from a traditional structured environment to a less secure urban lifestyle, are likely to show an increase in blood pressure. Personality factors such as time urgency and hostility may also be important. After the terrorist attacks of September 11, 2001, there was evidence of a nationwide increase in blood pressure (of approximately two mm Hg) during the month after the attack. </p>
<p>One of the best-studied models of chronic mental stress is exposure to job strain, defined by a combination of high demands and low control at work. Men who work in high-strain jobs have elevated blood pressure not only at work but also during sleep, suggesting that chronic stress can reset our blood pressure to a higher level. Women are less susceptible to this effect.&nbsp; </p>
<p><strong>Broken Heart Syndrome</strong></p>
<p>Takotsubo cardiomyopathy, or broken heart syndrome, is a disease of the heart muscle &mdash; not the vessels &mdash; often caused by stress. This sudden and temporary weakening of muscle in the heart can be triggered by emotional stress such as the death of a loved one, a break-up, or constant anxiety. Broken heart syndrome is a well-recognized cause of acute heart failure, lethal rhythm problems, and heart rupture. Some symptoms of the syndrome include congestive heart failure and heart attack originating in the front wall of the heart. Patients who come to the hospital exhibiting these indicators receive a coronary angiogram, which examines the blood vessels leading to the heart. When the angiogram does not reveal any significant blockages that would cause a heart attack, doctors often find that the patient has broken heart syndrome, instead. Provided that the individual survives their initial presentation, their heart function improves within two months. Takotsubo cardiomyopathy is more commonly seen in post-menopausal women.</p>
<p>Treatment is generally supportive in nature. Although patients with Takotsubo heart disease may actually have low blood pressure when they are seen, treatment with medicines to increase the blood pressure will usually make the disease worse. Since the disease is due to a high-adrenaline state, patients should not be given drugs to increase heart activity. Treatment recommendations include intra-aortic balloon pump, fluids, and blood pressure medications such as beta blockers or calcium channel blockers. </p>
<p>Despite the grave, initial presentation in some patients, most survive the initial acute event with a very low rate of in-hospital death or complications. Patients can expect a favorable outcome once recovery from the acute stage of the syndrome begins; and the long-term prognosis is excellent. Even when the heart&rsquo;s ability to pump is heavily compromised at first, it typically improves within the first few days and normalizes within a few months. </p>
<p><strong>Stress Management</strong></p>
<p>Fortunately, one can increase resistance to mental stress by strengthening physical health. Ways to do this include:</p>
<ul>
<li>Exercise regularly. Physical activity plays a key role in reducing and preventing the effects of stress. Get at least 30 minutes of exercise, three times per week. </li>
<li>Eat a healthy diet. Diets should be rich in fruits, vegetables, and unprocessed foods. Reduce caffeine and sugar. </li>
<li>Get enough sleep. </li>
<li>Meditate. </li>
<li>Use relaxation therapy like massage, deep breathing, or acupuncture. </li>
<li>Avoid alcohol, cigarettes, and drugs. Self-medicating with alcohol or drugs may provide an easy escape from stress, but the relief is only temporary. </li>
</ul>
<p>Prevention is the best intervention. By preventing and coping with stress more adequately, one can effectively modify cardiac risk factors and hence, strengthen the heart. </p>Tue, 24 Feb 2015 00:00:00 -0700{EC2A9BA7-D3AF-4620-9D2A-CAF83234D7A3}http://10.40.239.129/blogs/2015/02/should-healthcare-organizations-transform/Should Healthcare Organizations Transform?The whole healthcare world has been a buzz for a few years now with the notion of &ldquo;transformation.&rdquo; Ground swells were emerging around the country by the time the PPACA was signed into law in March of 2010. And then the floodgates burst open and organizations began a stampede into a new world of ACOs, Population Health, and Pay for Value. But then again, many have chosen to not jump onto the bandwagon and have continued to chart their course in the Fee for Service world. Which strategy is right?
<p>The answer is found hanging on the wall in your board room &ndash; your mission statement. Why does your organization exist? After spending an afternoon pondering that question, the direction you should pursue should be readily apparent. But from comments I&rsquo;ve heard from executives across the country, not everyone has yet spent an afternoon considering their mission. </p>
<p>Many have jumped headlong into the transformation world for reasons that may not have the power to sustain the course. Some are sailing into unchartered waters merely because they worry &ldquo;they will be left behind,&rdquo; or are being &ldquo;pressured by the market,&rdquo; or to &ldquo;get their physicians to the table.&rdquo; While such reasons may indeed compel an organization to action, they seem less than strategic and perhaps a bit dangerous. This transformation business is high stake stuff and signing risk contracts puts the organization, well, at risk! So organizations better be prepared and have good reason to embark on dramatic changes.&nbsp; </p>
<p>Some organizations have adopted a transformation strategy as a calculated opportunity to increase market share or revenue. For these organizations, the change is more about adopting a new revenue model than it is about transforming care.</p>
<p>Real transformation is about fundamental change. It&rsquo;s not incremental and it&rsquo;s not subtle. It&rsquo;s big. And the big changes we need are envisioned in the Triple Aim &ndash; better health, better healthcare, and affordable costs. These things will not happen by organizations nibbling on the edges of their business model or engaging in a defensive strategy. It will take a fundamental change in how we approach the delivery of healthcare with a true commitment to value for those we serve.&nbsp; </p>
<p>We have to bend the cost curve. Relatively few organizations, Intermountain being one of them, have acknowledged that reducing the rate of healthcare spending will result in less revenue to them! Our mission drives us to provide the highest value of care to the community we can and we believe that will result in the community spending less on healthcare.</p>
<p>So, yes; healthcare organizations not only should, they must transform themselves. But real transformation will be achieved only by those organizations that start with an uncompromising commitment to improving value to the community. I pin my hopes for the future of healthcare on them. </p>
<p>&nbsp;</p>
<p>&nbsp;</p>Mon, 23 Feb 2015 00:00:00 -0700{8F5FDA61-3574-4F80-993D-68360AD4ED1C}http://10.40.239.129/blogs/2015/02/what-is-integrative-medicine/What is Integrative Medicine?<p>Integrative medicine is based on the idea that you and your care provider work together to discover the best way to move toward healing. In practice, integrative medicine often involves combining natural therapies with conventional medicine when necessary. Natural therapies commonly used in integrative medicine include Chinese or other cultural-based medicine; nutritional, herbal, or bodywork therapies; or mind-body techniques. In contrast to this, alternative medicine implies <em>avoiding</em> conventional medicine completely.</p>
<p>The history of integrative medicine is interesting in that what is now thought of as complementary therapies such as herbalism, were considered medicine before the development of modern western medicine. Medical schools are beginning to take more of an interest in integrative medicine as well, and currently 113 of the 126 U.S. medical schools incorporate some integrative therapies into their curriculum. In 2015, the first board certification in integrative medicine will be available for physicians. Nurses are also using complementary therapies such as essential oils and energy healing in many hospitals. </p>
<p>A national survey that was conducted in 2012 and recently released reports that 33.2% of adults and 11.6% of children use complementary health practices. The most common approach was dietary and herbal supplements and the most common mind-body practice was yoga. Yoga practice has increased significantly since 2007 when the last survey was conducted and more children are using it as well. </p>
<p>Now that you know what integrative medicine is, here are three important things to keep in mind as you take advantage of this complementary approach to healing: </p>
<ol>
<li style="color: black;"><strong>Just because herbs and essential oils are &ldquo;natural&rdquo; doesn&rsquo;t mean that they are safe in every situation.</strong> If you are taking medications and want to take herbal or dietary products, you should talk to your care provider first so that drug-herb interactions can be addressed. Recently, there have been reports about herbal products that are contaminated or do not contain what the label says. In order to avoid this problem, you can research a company to find out if they test each batch of product that they sell for contaminants and content. You might also talk to a care provider who is familiar with and has researched different brands so that you are better informed. &nbsp;</li>
<li style="color: black;"><strong>A consultation with an integrative or holistic care provider may be very different from a typical medical appointment.</strong> Since integrative medicine is focused on the whole person, there will be many questions about all aspects of lifestyle, emotional, and spiritual health. This is necessary in order to find the source of a problem and not just treat the symptoms.</li>
<li style="color: black;"><strong>Nutrition is the most important complementary medicine.</strong> Many conditions can be prevented or improved just through proper food selection and preparation.</li>
</ol>Mon, 23 Feb 2015 00:00:00 -0700{E25A8077-EE41-45DE-918C-00D0F03F67F2}http://10.40.239.129/blogs/2015/02/proper-use-of-antibiotics-can-keep-your-family-safe-from-superbugs/Proper Use of Antibiotics can Keep Your Family Safe from &quot;SuperBugs&quot;<p class="p1">Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics, and at least 23,000 people die each year as a result of these infections, according to the Centers for Disease Control and Prevention (CDC).</p>
<p class="p1">Most recently, the superbug known as Carbapenem-resistant Enterobacteriaceae (CRE), has been linked to two deaths at a hospital in California, with many others potentially being exposed to the deadly bacteria.</p>
<p class="p2"><span style="line-height: 1.4em;">&ldquo;Antibiotic-resistant bacteria are a serious health issue here in the United States and abroad,&rdquo; said Eddie Stenehjem, MD, infectious disease physician with Intermountain Medical Center in Murray, Utah. &ldquo;Addressing the serious and even life-threatening nature of superbugs is going to take the efforts of everyone involved with infection control and antibiotic prescribing&ndash; from the doctor who prescribes antibiotics to the patient who takes them to the healthcare worker that provides care to these individuals.&rdquo;</span></p>
<p class="p2"><span style="line-height: 1.4em;">Antibiotics are life-saving drugs, but they are only meant to treat bacterial infections, not viral illnesses. If you are experiencing cold or flu-life symptoms you should talk to your doctor or pharmacist about how to relieve the symptoms, as opposed to using an antibiotic.</span></p>
<p class="p2"><span style="line-height: 1.4em;">For example, most sore throats do not require antibiotic treatment. According to the CDC, only 1 in 5 children seen by a doctor for a sore throat has strep throat, which should be treated with an antibiotic. The only way a doctor can confirm strep throat is by running a test. Every time someone takes an antibiotic they don&rsquo;t need, they increase their risk of developing a resistant infection in the future.</span></p>
<p class="p2"><span style="line-height: 1.4em;">Patients who are properly prescribed an antibiotic also play a role in the possible development of superbugs. Too often, patients using an antibiotic stop taking the antibiotic once they &ldquo;feel better.&rdquo; This dangerous practice can allow the bacteria to build&nbsp;resistance to the antibiotic drug.</span></p>
<p class="p2"><span style="line-height: 1.4em;">&ldquo;Doctors hold the responsibility of properly prescribing antibiotics to their patients when appropriate,&rdquo; said Dr. Stenehjem. &ldquo;When properly prescribed, the patient holds the responsibility of completing the required doses. These two very important practices will play a vital role in preventing the creation of superbugs, thus increasing the effectiveness of antibiotics in fighting infections."</span></p>Mon, 23 Feb 2015 00:00:00 -0700